{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:34:31Z","timestamp":1787754871423,"version":"build-2784847793"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"23","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,12,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The purpose of the present study was to estimate the cost-effectiveness of treating displaced, intra-articular distal radial fractures with volar locking plate fixation compared with augmented external fixation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A cost-utility analysis was conducted alongside a randomized, clinical trial comparing 2 surgical interventions for intra-articular distal radial fractures. One hundred and sixty-six patients were allocated to either volar locking plate fixation (84 patients) or external fixation (82 patients) and were followed for 2 years. Health-related quality of life was assessed with the EuroQol-5 Dimensions and was used to calculate patients\u2019 quality-adjusted life-years (QALYs). Resource use was identified prospectively at the patient level at all follow-up intervals. Costs were estimated with use of both a health-care perspective and a societal perspective. Results were expressed in incremental cost-effectiveness ratios, and uncertainty was assessed with use of bootstrapping methods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The average QALY value was equivalent between the groups (1.70463 for the volar locking plate group and 1.70726 for the external fixation group, yielding a nonsignificant difference of \u22120.00263 QALY). Health-care costs were equal between the groups, with a nonsignificant difference of \u20ac52 (p = 0.8) in favor of external fixation. However, the external fixation group had a higher loss of productivity due to absence from work (5.5 weeks in the volar locking plate group compared with 9.2 weeks for the external fixation group; p = 0.02). Consequently, the societal costs were higher for the external fixation group compared with the volar locking plate group (\u20ac18,037 compared with \u20ac12,567, representing a difference of \u20ac5,470; p = 0.04) in favor of the volar locking plate group. Uncertainty analyses showed that there is indifference regarding which method to recommend from a health-care perspective, with volar locking plate treatment and external fixation having a 47% and 53% likelihood of being cost-effective, respectively. From the societal perspective, volar locking plate treatment had a 90% likelihood of being cost-effective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>External fixation was less cost-effective than volar locking plate treatment for distal radial fractures from a societal perspective, primarily because patients managed with external fixation had a longer absence from work.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Economic and Decision Analysis\n                      <jats:underline>Level I<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.19.01288","type":"journal-article","created":{"date-parts":[[2020,9,18]],"date-time":"2020-09-18T18:12:30Z","timestamp":1600452750000},"page":"2049-2059","source":"Crossref","is-referenced-by-count":6,"title":["Cost-Effectiveness of Volar Locking Plate Compared with Augmented External Fixation for Displaced Intra-Articular Wrist Fractures"],"prefix":"10.2106","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8504-3821","authenticated-orcid":false,"given":"Ola-Lars","family":"Hammer","sequence":"first","affiliation":[{"name":"Akershus University Hospital, Akershus, Norway"},{"name":"University of Oslo, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3566-9516","authenticated-orcid":false,"given":"Rune Bruhn","family":"Jakobsen","sequence":"additional","affiliation":[{"name":"Akershus University Hospital, Akershus, Norway"},{"name":"University of Oslo, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8330-7141","authenticated-orcid":false,"given":"Stale","family":"Clementsen","sequence":"additional","affiliation":[{"name":"Akershus University Hospital, Akershus, Norway"},{"name":"University of Oslo, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4629-9434","authenticated-orcid":false,"given":"Hendrik","family":"Fuglesang","sequence":"additional","affiliation":[{"name":"Akershus University Hospital, Akershus, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4997-5426","authenticated-orcid":false,"given":"Gudrun Waaler","family":"Bjornelv","sequence":"additional","affiliation":[{"name":"University of Oslo, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7674-1572","authenticated-orcid":false,"given":"Per-Henrik","family":"Randsborg","sequence":"additional","affiliation":[{"name":"Akershus University Hospital, Akershus, Norway"},{"name":"Hospital for Special Surgery, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,9,17]]},"reference":[{"issue":"6","key":"bib1-20230810","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1016\/S8756-3282(01)00614-7","article-title":"Epidemiology of fractures in England and Wales","volume":"29","author":"van Staa","year":"2001","journal-title":"Bone."},{"issue":"8","key":"bib2-20230810","doi-asserted-by":"crossref","first-page":"775","DOI":"10.2106\/JBJS.938ebo","article-title":"American Academy of Orthopaedic Surgeons clinical practice guideline on: the treatment of distal radius fractures","volume":"93","author":"Lichtman","year":"2011","journal-title":"J Bone Joint Surg Am."},{"issue":"7","key":"bib3-20230810","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1302\/0301-620X.96B7.33149","article-title":"The operative treatment of fractures of the distal radius is increasing: results from a nationwide Swedish study","volume":"96-B","author":"Mellstrand-Navarro","year":"2014","journal-title":"Bone Joint J."},{"issue":"9","key":"bib4-20230810","doi-asserted-by":"crossref","first-page":"1855","DOI":"10.2106\/JBJS.G.01569","article-title":"Fractures of the distal part of the radius. 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